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SOME  PROBLEMS  OF  THE  INSTITUTION 
LIBRARY  ORGANIZER  IN 


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SOME  PROBLEMS  OF  THE  INSTITUTION  LIBRARY  ORGANIZER  IN 

THE  STATE  HOSPITALS* 


By  EDITH  KATHLEEN  JONES, 

Librarian  at  McLean  Hospital,  Waverley,  Mass. 


Last  year  I had  the  pleasure  of  telling 
you  something  of  library  work  in  one  of 
the  large  private  hospitals  for  the  insane; 
this  year  I want  to  speak  of  some  of  the 
problems  the  institution  organizer  will 
meet  when  she  undertakes  to  set  in  order 
the  libraries  of  the  state  hospitals. 

In  the  first  place,  unless  she  is  fortunate 
enough  to  be  appointed  by  the  State  Board 
of  Control  or  State  Board  of  Insanity  or 
their  equivalent,  she  may  at  times  feel 
that  she  is  looked  upon  a little  bit  as  an 
outsider  by  the  hospital  staff,  as  one  who 
does  not  understand  hospital  conditions 
and  who  belongs  to  an  entirely  different 
order  of  things.  She  may  even  meet  what 
seems  to  her  indifference  or  actual  antag- 
onism on  the  part  of  a few  superintendents. 

The  fact  is,  the  library  to  librarians  is 
of  supreme  importance,  but  the  library 
to  the  average  hospital  superintendent  is 
merely  one  method  of  providing  entertain- 
ment or  employment  for  his  patients.  He 
is  much  more  interested  in  the  new  social 
service  movement  and  the  study  of  eugen- 
ics and  heredity  than  he  is  in  the  general 
library,  which,  to  his  mind,  is  simply  a 
part  of  the  therapeutic  system  and  even 
as  such  ranks  far  below  useful  employment 
and  arts  and  crafts  work. 

This  indifference  or  antagonism  does  not 
arise  from  any  personal  feeling  nor  is  it 
confined  to  the  library.  It  is  the  natural 
outcome  of  the  peculiar  organization  de- 
manded in  a hospital  for  the  insane,  a 
general  distrust  of  any  outside  interference 
in  any  department,  and  a thorough  con- 
viction that  each  hospital  is  entirely  com- 
petent to  manage  its  own  affairs.  In  one 
state  the  state  board  refused  the  offer  of 
the  state  library  committee  to  organize 
its  institution  libraries  for  these  very  rea- 
sons. In  another  state,  where  the  possi- 
bility of  the  state  board  appointing  an 

*Read  before  the  League  of  Library  Com- 
missions, at  the  Conference  of  the  American 
Library  Association,  Kaaterskill,  N.  Y.,  June, 
1913. 


institution  librarian  of  its  own  is  under 
discussion,  one  superintendent  remarked 
that  he  “could  only  say  this;  if  it  must 
come  he  was  thankful  it  was  coming  from 
the  inside,  through  the  board  and  from  one 
who  knew  hospital  conditions.” 

Another  reason  for  this  seeming  indif- 
ference on  the  part  of  the  superintendents 
is  that,  in  the  East  at  any  rate,  a state 
hospital  is  always  poor.  It  is  poor  and  it 
is  crowded,  and  its  superintendent  is  har- 
rassed  with  having  his  requests  for  better 
accommodations  for  his  patients,  a new 
power  house,  larger  kitchens  and  laundries, 
or  quarters  for  his  married  men  nurses 
turned  down;  with  trying  to  get  larger  ap- 
propriations from  the  state  legislature; 
with  endeavoring  to  feed  and  clothe  and 
house  1,200  patients  on  an  appropriation 
and  in  quarters  designed  for  1,000  at  the 
most.  He  probably  has  cut  down  his  ex- 
penses in  every  conceivable  direction,  and 
he  can  not  see  the  use  of  spending  money 
for  books  which  the  majority  of  his  pa- 
tients will  not  read.  And  there  is  this  to 
be  said  for  his  point  of  view,  that  while 
there  are  many  educated  and  cultivated 
persons  in  all  the  state  hospitals,  the  ma- 
jority of  them  are  foreigners  and  illiterates 
from  the  mill  and  factory-hand  classes  and 
from  the  slums  of  the  cities.  In  New  York 
state  alone,  in  1906,  forty-six  per  cent  of 
the  whole  number  of  patients  admitted  to 
the  New  York  hospitals  were  of  foreign 
birth.  And  I might  add,  to  show  the 
menace  of  the  class  of  people  we  are  let- 
ting into  our  country,  that  forty-six  per 
cent  of  the  insane  were  aliens,  while  only 
twenty-six  per  cent  of  the  whole  popula- 
tion of  the  state  were  of  foreign  birth.  Add 
to  these  the  outcasts  from  the  slums  and 
you  have  a good  idea  of  the  make-up  of 
the  state  hospitals  and  asylums,  and  you 
will  not  wonder  that  many  superintendents 
shake  their  heads  when  libraries  are  men- 
tioned. 

It  would,  therefore,  seem  to  be  one  of  the 
duties  of  the  organizer  to  prove  to  the 


superintendent  that  even  if  three-fifths  of 
his  patients  are  illiterate,  reading  should 
be  provided  for  the  educated  two-fifths; 
that  she,  from  her  knowledge  of  books  and 
editions,  can  provide  a thoroughly  readable 
library  which  will  meet  the  requirements 
of  all  classes,  from  college  professors  to 
the  dregs  of  humanity,  for  a much  less 
sum  than  he  can  do  it,  and  from  her 
experience  she  can  interest  the  patients  in 
hooks.  For  after  you  have  the  library,  you 
still  have  a set  of  people  to  deal  with 
who  lack  initiative  and  must  be  aroused 
to  interest  in  anything.  She  must  also 
impress  upon  him  that  shelf-and-book  or 
even  accession  numbers  mean  nothing,  and 
that  when,  as  in  one  library  I know,  all 
the  books  are  covered  and  there  is  no  hint 
of  author  or  title  on  the  back,  the  library 
is  converted  into  a sort  of  literary  grab-bag 
which  is  funny  to  the  librarian  but  exas- 
perating to  the  patient.  She  must  con- 
vince him  that  an  unclassified  library  rep- 
resents a tremendous  waste,  especially 
when  it  is  not  supplemented  by  a subject 
catalog.  She  must  be  able  to  prove  to 
him  from  the  experience  of  other  hospitals 
that  the  old-fashioned  method  of  letting  a 
library  run  itself  is  not  conducive  to 
growth  and  that  there  must  be  some  one 
whose  chief  duties  are  to  the  library.  She 
can  assure  him  from  figures  that  he  is  not 
‘getting  out  of  his  library  what  he  should, 
if  out  of  1,000  patients  only  60  use  the 
library  during  the  year  and  50  books  a 
week  is  a large  circulation.  She  can  tell 
him  of  one  hospital  of  220  patients  which 
has  from  75  to  100  regular  readers,  not 
counting  nurses  and  employees,  and  aver- 
ages 25  books  a day,  or  8,900  a year;  of  an- 
other of  about  the  same  size  which  often 
gives  out  50  books  a day;  of  a third,  which, 
with  a population  of  2,000  gave  out  last 
year  15,862  volumes  to  344  persons.  She 
can  guarantee  him  that  if  he  will  let  her 
weed  out  obsolete  stuff  and  fill  in  with  the 
sort  of  books  the  patients  want  and  train 
some  patient,  nurse  or  stenographer  to  act 
as  librarian  in  her  absence  at  other  hospi- 
tals, his  library  circulation  will  be  doubled 
or  trebled  the  first  year. 

Having  convinced  the  superintendent  of 
the  utility  of  the  organized,  central  library, 
the  institution  librarian  is  now  free  to 
turn  her  attention  to  the  patients,  getting 


acquainted  with  them,  learning  their  tastes 
in  books,  interesting  them  in  reading  and 
in  pictures.  And  just  here  I would  say 
that  in  the  state  hospitals  the  doctors  are 
always  glad  to  have  anything  new  suggest- 
ed in  the  way  of  employment,  and  that  if 
the  organizer  can  manage  it  so  that  the 
patients  can  help  her  in  the  care  of  the 
charging-system,  mending  and  cataloging, 
her  efforts  will  be  much  appreciated  by  all 
concerned. 

The  institution  organizer  will  soon  find 
that  each  hospital  differs  from  every  other 
in  construction,  management,  and  especial- 
ly in  the  character  of  illness.  The  asylums 
for  the  chronic  insane  present  the  most 
hopeless  feature,  yet  even  here  there  are 
enough  who  read-  to  make  it  worth  while 
to  furnish  libraries.  Moreover,  in  the  asy- 
lums, the  nurses  have  to  be  taken  into 
account.  Their  work  is  so  hopeless  and 
uninteresting  compared  with  that  in  hos- 
pitals for  acute  and  recoverable  cases  that 
more  must  be  done  for  them  in  order  to 
get  and  keep  even  ordinarily  good  attend- 
ants. And  where,  as  in  many  cases,  the 
chronic  insane  are  being  transferred  to 
farm  colonies  way  out  in  the  country,  far 
from  any  city  or  even  large  town,  the  li- 
brary can,  if  it  will,  help  very  decidedly  by 
offering  means  of  study  and  education  to 
the  nurses  and  staff  as  well  as  diversion 
to  the  patients.  Therefore,  one  can  ven- 
ture to  buy  for  an  asylum  a much  better 
selection  of  books  from  the  point  of  view 
of  general  culture  than  for  the  ordinary 
hospital. 

I have  said  so  often  that  a hospital  li- 
brary must  be  formed  for  entertainment, 
not  for  education,  that  it  must  be  simple  in 
organization  and  carried  along  on  uncon- 
ventional lines,  that  I speak  of  these  points 
again  only  to  emphasize  them.  If  one 
looks  upon  institutional  work  from  the 
point  of  view  of  educative  influence  it  is 
discouraging  work;  but  if  one  thinks  of 
it  as  an  adjunct  to  the  therapeutic  service 
of  the  hospital,  as  a means  of  bringing 
some  pleasure  or  at  least  forgetfulness  of 
self  for  a time  to  an  afflicted  class  and  em- 
ployment for  hours  which  otherwise  would 
be  passed  in  complete  idleness  and  utter 
dejection,  it  is  inspiring  work.  But  in  the 
selection  of  books  this  point  of  view  must 
be  kept  always  in  mind. 


Yet  this  is  just  what  those  unaccustomed 
to  hospital  conditions  fail  to  grasp.  Not 
three  months  ago  a hospital  in  a far-off 
western  city  sent  a representative  to  see 
our  library  and  get  all  the  information  he 
could  in  regard  to  the  sort  of  books  they 
should  put  into  their  beautiful  and  expen- 
sive new  buildings.  I showed  him  a list 
of  some  1,200  of  our  most  popular  books 
selected  as  a basis  for  the  little  catalog 
Miss  Carey,  Miss  Robinson,  Miss  Waugh 
and  I have  made  out  and  annotated,  and 
which  is  now  being  printed  by  the  A.  L.  A. 
Publishing  Board.  The  first  thing  he 
noticed  was  the  omissions.  “Why,”  said 
he,  looking  at  Science,  “you  have  nothing 
by  Spencer,  or  Darwin  or  Huxley  on  this 
list.  Aren’t  they  the  standard  thing? 
Oughtn’t  I to  get  them  for  our  library?” 
“Not  if  you  want  a library  which  will  be 
read,”  was  my  prompt  reply,  and  I showed 
him  the  records  of  our  sets  of  these  scien- 
tists, taken  out  at  the  most  three  or  four 
times  in  the  history  of  the  library. 

A year  or  so  ago  I attempted  to  find  out 
from  our  cards  just  what  was  the  most 
popular  sort  of  fiction  in  our  library.  Of 
course  the  book  of  the  moment  is  the  one 
read  at  the  moment,  so  it  would  be  mani- 
festly unfair  to  include  these  and  I took 
only  those  books  published  prior  to  1901. 
It  may  interest  you  to  know  in  their  order 
the  25  most  read  books,  that  is,  of  the  old 
favorites.  The  date  unfortunately  excludes 
Mr.  Pratt,  the  Virginian,  Kim,  Rex  Beach 
and  Oppenheim.  They  are,  The  Choir  In- 
visible, Janice  Meredith,  Saracinesca,  Sant’ 
Ilario,  Don  Orsino,  Vanity  Fair,  The  Lilac 
Sunbonnet,  Old  Chester  Tales,  Dr.  Laven- 
der’s People,  When  Knighthood  was  in 
Flower,  The  Sowers — taken  out  20  times 
in  the  last  three  years;  The  Seats  of  the 
Mighty,  The  Battle  of  the  Strong,  Adven- 
tures of  Sherlock  Holmes,  Memoirs  of  Sher- 
lock Holmes,  Treasure  Island,  Cape  Cod 
Folks  and  The  Right  of  Way,  22  times; 
A Little  Moorland  Princess,  Dorothy  Ver- 
non, Kidnapped  and  The  Cardinal’s  Snuff 
Box  25  times;  Richard  Carvel  29  times; 
The  Old  Ma’amselle’s  Secret  40  times  and 
The  Second  Wife  by  Miss  Marlitt  43  times. 
This  shows  pretty  conclusively  that  even 
our  people,  all  of  whom  belong  to  the  cul- 
tivated and  educated  class,  want  light,  in- 
teresting stories  of  romance  and  adven- 


ture, and  the  average  state  hospital  reader 
wants  something  even  lighter  than  these. 

I have  been  asked  again  and  again  if 
the  right  reading  really  cures.  One  dare 
not  affirm  this;  its  influence  is  negative 
rather  than  positive.  But  I can  say  this: 
I have  known  of  many  cases  outside  as 
well  as  in  the  hospital  where  persons  have 
been  positively  harmed  by  morbid  or  hys- 
terically sentimental  books.  Our  people 
are  inclined  to  be  pretty  emotional  anyway, 
and  whatever  appeals  to  that  side  is  to  be 
deplored. 

To  sum  up  the  qualities  which  determine 
the  suitability  of  books  for  a hospital  li- 
brary, I can  do  no  better  than  quote  from 
the  “Foreword”  of  the  catalog  mentioned 
above: 

“In  making  this  list  the  editors  have  en- 
deavored to  keep  in  mind  the  following 
points: 

1.  Books  in  a hospital  are  for  recrea- 
tion, not  for  instruction,  and  therefore 
should  consist  principally  of  fiction,  pic- 
ture books,  travel,  biography,  light  and 
popular  science  and  outdoor  books. 

2.  They  must  be  wholesome — not  mor- 
bid, or  gruesome,  or  depressing.  Good  de- 
tective stories  and  tales  of  adventure,  how- 
ever thrilling,  if  not  horrible,  and  if  they 
do  not  make  vice  attractive,  are  to  be  rec- 
ommended, as  they,  more  than  almost  any- 
thing else,  hold  the  attention. 

3.  Illustrated  books  and  books  of  pic- 
tures are  invaluable,  as  a patient  often  will 
look  at  pictures  when  he  is  too  ill  to  read. 

4.  The  newest  fiction  is  called  for  and 
read,  yet  the  old  favorites  remain  much 
in  demand.  With  so  much  ephemeral  stuff 
among  the  “best  sellers,”  it  is  a delicate 
task  to  select  the  really  good  novels  which 
will  last,  and  there  is  a great  temptation 
to  fall  back  on  the  old  and  tried  books 
to  the  exclusion  of  the  more  modern. 
The  editors  have  tried  to  combine  the  two 
in  just  proportion,  and  also  to  give  a few 
titles  of  the  better  class  of  the  “second 
rate”  which  have  proved  popular. 

5.  It  is  not  enough  to  provide  books  for 
those  who  wish  to  read.  There  are  always 
many  patients  who  are  unable  to  take  any 
initiative  towards  selecting  any  form  of 
entertainment  or  employment  for  them- 
selves, and  for  these  should  be  provided 


light  and  simple  stories  which  will  not  tax 
the  brain  or  require  any  concentration  of 
attention,  but  which  will  serve  to  stimulate 
their  interest  in  things  outside  themselves. 
These  are  not  necessarily  children’s  books, 
but  often  the  simple  language  and  quiet 
wholesomeness  of  certain  books  for  young 
people  will  bridge  a patient  over  this  period 
of  mental  inadequacy  and  pave  the  way  to- 
wards a real  enjoyment  of  maturer  reading. 

In  addition  to  these  five  simple  rules  for 
selecting  the  reading  for  a hospital  library, 
the  editors  would  emphasize  another  very 
important  point:  Many  of  the  readers  will 
be  elderly  persons  with  failing  eyesight, 
who  demand  large,  clear  type.  This  is 
hard  to  procure  in  cheap  editions  of  stand- 
ard authors  and  old  favorites,  but  it  is 
suggested  that  it  is  well  worth  while  to 
take  a little  pains  in  selection  and  even 
to  pay  a higher  price,  in  order  to  get  an 
edition  of  convenient  size,  shape  and 
weight,  in  serviceable  binding,  with  large, 
clear  type.  Such  an  edition  will  last  longer 
and  will  invite,  not  repel  the  reader. 

Complete  sets  of  the  works  of  standard 
authors,  with  the  exception  of  Shakespeare, 
Scott,  Dickens,  and  possibly  George  Eliot, 
are  not  recommended  for  hospitals.  Only 
a few  of  the  more  popular  stories  of  each 
will  be  read.” 

I want  to  say  just  a word  in  regard  to 
he  housing  of  hospital  libraries.  Of  course 
the  ideal  arrangement  is  a separate  build- 
ing which  is  open  all  the  time,  but  I know 
of  only  three  or  four  such  in  the  country. 
In  most  state  hospitals  the  library  was  an 
afterthought  and  the  books  are  crowded 
into  one  or  two  more  or  less  inaccessible 
rooms  to  which  the  patients  can  come  only 
once  or  twice  a week  and  which  can  not 
possibly  be  made  attractive.  Often  there  is 
absolutely  no  other  room  to  be  had  in  the 
hospital  and  the  librarian  must  make  the 
most  of  it  and  do  her  utmost  to  beautify 
it  with  rugs  and  baskets  made  by  the  pa- 
tients and  flowers  from  the  hospital  green- 
houses. But  sometimes  a little  ingenuity 
will  solve  the  problem  in  some  such  unique 

*This  prophecy  has  come  true  sooner  than 
was  expected.  In  October,  1913,  McLean 
Hospital  introduced  into  its  training-school 
for  nurses  a course  on  “The  History  of  the 
English  novel,”  given  by  the  librarian  and 
designed  as  a foundation  on  which  to  base 
criticism  of  current  fiction  and  help  the 
nurses  in  selecting  books  for  patients. 


way  as  in  the  State  Infirmary  at  Tewks- 
bury, Mass.,  where  the  superintendent  con- 
ceived the  idea  of  moving  their  very  good 
little  library  (classified  and  cataloged  too) 
from  its  one  small  dark,  inaccessible  room 
in  the  administration  house  to  the  large, 
light  chapel  which  hitherto  stood  idle  six 
days  in  the  week.  Here  low  shelves  have 
been  built  in  between  the  windows  on  the 
wide  side  aisles  and  stacks  fitted  into  the 
alcove  rooms  each  side  the  chancel.  Long 
narrow  tables  with  plenty  of  books  and 
magazines  have  been  placed  in  these  aisles 
and  the  library  is  now  open  practically  all 
the  time. 

The  Hospital  for  Epileptics  at  Monson, 
Mass.,  has  met  its  problem  somewhat  dif- 
ferently. The  superintendent  here  is  hav- 
ing two  large  sunny  rooms  fitted  up  with 
bookshelves,  one  for  the  men  where  they 
can  smoke  and  one  for  the  women  where 
they  can  sew.  These  shelves  will  be  kept 
filled  with  books  from  the  central  library 
(in  an  office  in  the  administration  house 
which  it  shares  with  the  medical  library) 
administered  by  the  stenographer-librarian, 
but  under  the  direct  supervision  of  a pa- 
tient for  each  room.  The  patients  them- 
selves are  very  enthusiastic  over  the  pro- 
posed change  and  have  made  out  lists  of 
books  they  want. 

In  Massachusetts,  the  ideal  so  far  as  use 
of  the  library  goes,  is  found  at  the  Fox- 
borough  Hospital  for  Inebriates,  where 
only  men  patients  are  admitted.  Here  they 
have  a separate  building  containing  one 
large  room  with  low  bookcases  all  around 
it  and  two  tables  covered  with  periodicals 
and  newspapers  in  the  center.  Here  the 
men  can  come  when  their  day’s  work  is 
over  or  at  the  noon  hour  and  read  and 
smoke. 

I wish  I had  time  to  speak  of  the  im- 
portance of  interesting  the  nurses  in  the 
library  and  getting  their  co-operation,  and 
of  the  possibility  of  holding  classes  on 
books  and  reading  for  them.  I know  of  no 
hospital  where  they  have  time  for  such 
classes  at  present,  but  there  is  a movement 
on  foot  towards  requiring  better  educa- 
tion as  a condition  for  entering  the  train- 
ing schools  for  the  general  hospitals,  and 
some  day  some  hospital  will  inaugurate 
classes  in  literature.* 


